Patient-centred outcomes research: brave new world meets old institutional policies. Fam Pract 2017 Jun 01;34(3):296-300
Date
01/27/2017Pubmed ID
28122843Pubmed Central ID
PMC5865891DOI
10.1093/fampra/cmw129Scopus ID
2-s2.0-85019166515 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
BACKGROUND: Engaging patients across the research trajectory supports research that is generalizable, high quality, timely and actionable. However, this approach comes with challenges and opportunities as investigators and engaged patient stakeholders encounter institutional policies around patient engagement, privacy and research participant protection.
OBJECTIVE: To describe the resolution and impact of quandaries arising when patient stakeholders' values and preferences conflicted with institutional policies.
METHODS: Case study from a Patient-Centered Outcomes Research Institute-funded trial.
RESULTS: The first example focuses on the tension between the health care organization's requirements for background checks for all patient advisors and the funders' requirement to engage hard-to-reach populations. To create an environment of mutual trust and respect with patient stakeholders, the research team decided against imposing background checks. All 53 patient and parent advisors have served continuously for 2 years and meeting attendance exceeds 95%. The second example describes parent stakeholders' role in revising a letter informing patients about a privacy violation. Among 49 families affected by and informed about this violation, 35 (71%) agreed to participate. The third example focuses on how patient stakeholder preferences about study reminders conflict with the 1996 Health Insurance Portability and Accountability Act rules. While patient stakeholders strongly endorsed text message reminders, regulations and technology do not permit reminders with enough detail to ensure clarity. Although retention rates exceeded 90%, attendance at study appointments was below 75% and below 60% for minority and low socio-economic status families.
CONCLUSION: Patient engagement positively impacts research. Resolving conflicts between patient-engaged research and existing institutional policies and regulations would allow this impact to become fully realized.
Author List
Chung JS, Young HN, Moreno MA, Kliems H, Cox EDAuthor
Jessica S. Chung MD Adjunct Instructor in the Obstetrics and Gynecology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Health Insurance Portability and Accountability ActHumans
Organizational Policy
Patient Outcome Assessment
Patient Participation
Privacy
United States
